A note on language: The terms “over-the-counter” (OTC) and “off-the-shelf” (OTS) are used interchangeably to refer to products that are widely available on the market, to any customer, with or without the guidance or advice of a healthcare professional.

An over-the-counter (OTC) product is typically mass-produced, available without prescription, and can be used independently by an individual with or without professional advice.

There are times when an OTC device is utilized by Canadian Certified Pedorthists, including:

Urgency: an acute medical condition – a diabetic ulcer, for example – might require immediate relief through the offloading of pressure. An OTC product might bring relief while a custom-made orthosis is being fabricated.

Temporary need: short-term use for growing children or pregnant women with less severe foot or lower limb issues.

Minor conditions: small abnormalities. More serious or chronic abnormalities, however, require custom-made products.

Minimal activity: for a patient who is not on his/her feet very much, or is bed- or wheelchair-bound and rises only occasionally to transfer from bed to chair or to washroom.

Cost factors: as an alternative for patients who are unable to afford a custom-made product.

As a first step: as a trial to determine how a patient might respond to custom-made products.

Pedorthists are required to clarify on billing statements whether a device was OTC or custom-made. If a pedorthist alters an OTC device, it can be described as a “modified” product, not a “custom-made” product.

[info_box title=”OUR POSITION”]While there are times when an OTC product might provide a measure of relief for a patient with foot pain, it does not provide the support, control, or specificity of a custom-made product. In fact, pedorthists will often see patients who have already tried OTC products and have found no relief. Therefore, it is essential that the clinician’s judgment be respected in addressing the patient’s pedorthic needs.

Other points:

  • OTC products cannot provide accurate biomechanical advantages to patients with severe misalignment.
  • OTC products cannot be expected to be absolutely suitable for any given patient.
  • The value of heat-mouldable OTC products is enhanced when moulded by a Canadian Certified Pedorthist.


  • OTC products have a shorter lifespan than custom-made devices, and must be replaced frequently if used for a long-term or chronic condition.
  • The material selection and properties of OTC devices, as well as the limited capacity to modify them, restricts a clinician’s control over the product and can therefore affect patient outcomes.

Download – A Resource for Canada’s Insurance Industry as a PDF
VIDEO: Off the Shelf Orthotics